Wednesday, April 25, 2007

The American Diet: Manufacturing Ill Health

This chart shows how the U.S. stacks up against other nations in citizens over the age of 25 with a body mass index (BMI) of over 30: If you're not sure what the BMI measures, or what your own BMI is, go to the National Institute of Health BMI calculator.

The basic idea is that weight and height are relational: the taller you are, the higher your weight. The criticism of the BMI is that very muscular or stout people end up with a high BMI number even though they are fit. There is a weakness in any simple metric, of course, but the BMI is a generally accurate assessment of "healthy weight."

As expected, developing nations like Egypt and Asian nations with low-fat, low protein cuisines like Japan have few obese adults. The surprise is that European nations with high-fat diets rich in chocolate and cheeses like France are relatively low. (Switzerland, though not shown, was just above Japan despite a very high per capita intake of chocolate.)

This suggests that fat alone (or sweets alone) cannot be singled out as the "cause" of obesity. Now please don't take this entry personally if you are overweight. By the NIH standards of what constitutes "normal weight," some 2/3 of American adults are overweight or obese.

Since this wasn't the case 40 years ago, we have to ask what's different now. Could it be the genetic composition of U.S. citizenry? While immigration has brought an influx of Hispanic and Asian peoples into the U.S. in those 40 years, there is no evidence to support the notion that an influx of obese people or people tending toward obesity has skewed the genetic pool to the point that fully 1/3 of the adult population is unhealthily heavy.

Here are the usual suspects: declining physical activity, growth of fast food, hurry-up meals and harried parents who have given up control of their children's diets. There is of course some truth in each of these assertions, but the elephant in the room nobody seems to talk about is this: Consuming the American food industry's products inevitably lead to obesity and poor health.

Now before you freak out and start emailing me about "personal responsibility" and related issues, allow me to relate my own struggle to find food products which aren't basically deadly.

Yes, we are each responsible for our own food purchases and intake. But to narrow the diseases of obesity down to an individual failure to control caloric intake is to miss this point: There is virtually no healthy food available in any American supermarket beyond the produce, bread, dairy/soy and fresh meat/fish aisles.

As you may recall from earlier posts, I discovered I have high blood pressure last year--not super-dangerous like 180/100, but readings in the 130-140 / 90 range. My doctor explained that if there is anything we know for sure, it's that high blood pressure greatly increases the risks of stroke and heart disease. Slam dunk, no debate, end of story. He recommended that I start taking medications to lower my blood pressure.

As long-time readers know from Zombiestra and other drug parodies I've created here, I am not a big fan of medications, especially those with side-effects and those whose interactions with other meds have been poorly studied, i.e. all of them. My BMI is 21.8, well within the "normal weight" range of 18.5-24.9, so my weight obviously wasn't the key factor. Though my doctor cited genes as the primary cause, I suspected lifestyle might have some wee effect as well.

Thanks to polymath contributor U. Doran, who sent me some links on salt and blood pressure, I discovered that just as we've been told for decades, salt is the key factor (along with weight) in controlling blood pressure. Stress and diet are of course also factors, but it's harder to measure the impacts of these complex metrics.

Here is a long-term study which supports the connection between lowering salt intake and lowering the risk of heart disease: Scientists prove that salty diet costs lives; "Eating less salt reduces the chances of suffering a heart attack or stroke, the first long-term study of salt’s impact on health confirms today."

The usual image of a high-salt diet is someone shaking loads of salt on their steak or veggies. Too bad it's not this simple. A careful study of standard American manufactured foods has led me to conclude that even if you don't add a single grain of salt to a single morsel of food, you are eating far more salt than is healthy. And by manufactured foods I don't mean just frozen dinners; I mean canned beans, prepared salads, packaged noodles, sausage, snacks, etc. Everything which isn't fresh produce, bread. dairy/soy or fresh meat/fish, i.e. foods which require some preparation.

The "recommended salt intake per day" is about 2300 mg (milligrams), which in terms of limiting your risk of dying prematurely should be viewed as a maximum best avoided--about half that would be a better target. So let's "eat healthy"--low fat and low sugar--and see how we do:Breakfast: Wheat Chex: 420 mg of salt and a low-fat Aidells sausage: 300 mgLunch: Trader Joe's mushroom rice noodle soup bowl: 700 mg one bag of low-fat chips: 600 mgdinner: organic garbanzo beans, 390 mg, salad with blue-cheese dressing with bacon bits (500 mg), frozen low-fat enchiladas (750 mg.)

Total salt content of "low calorie, restricted fat" diet: 3660 mg.

What can we say about this level of salt intake? It raises the risk of stroke and heart disease. Put simply: it will very likely take years off your life. So next time you're in a fast food outlet or a supermarket, try to find something you can eat that won't kill you. It will be a challenge, I guarantee you.

I have lowered my blood pressure to 117-128 / 72-81 by following a modest regime of stress reduction, salt reduction, slightly increased exercise and substituting fresh ginger tea for caffeinated black or green tea (which I still drink in small quantities). To reduce my salt intake, here's a short list of what I no longer eat:chips: out, too much saltfries: out, too much saltsausage: out, too much saltfast food in general: out, too much saltsalted nuts: out, too much saltcanned goods: out, too much saltmost cereals: out, too much saltbottled salad dressings: out, too much saltsports drinks: out, too much saltpre-packaged salads: out, too much salt in the dressingfrozen meals: out, too much saltpackaged snacks: out, too much saltpackaged noodles: out, too much salt In other words, literally everything in the supermarket except the fresh produce and the meat counter (with rare exceptions like frozen blueberries, which are essentially produce anyway).

If you want to locate the cause of American obesity and poor health, look no further than the label on virtually every item in the American supermarket.

One last story on deceptive labeling: I was looking for some plain old peanut butter, a product you'd think you could find somewhere which hasn't been adulterated with added sugar and hydrogenated oil (to keep the natural peanut oil from separating.) I happened upon some "organic peanut butter" in Costco and my hopes were raised that here was a genuine unadulterated jar of peanut butter (OK, with some salt added).

No way. The "organic" peanut butter was loaded with hydrogenated palm oil. Is this dollop of goop also "organic" and therefore "good for you"? If this isn't deceptive, shall we call it misleading, or purposefully confusing? Whatever label you choose, it's clear that the American food products industry neither manufactures healthy products nor enables consumers to make healthy choices.

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